Active NPI
Shannon Marie Pavas, LCSW
- Clinical Social Worker
- Cresskill, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05779900
- Practice address
- 155 County Rd
Cresskill, NJ 07626-2200 - Phone
- (201) 803-9433
- NPI assigned
- Apr 11, 2018
- Last updated
- Apr 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05779900 | NJ | Primary |
Addresses
Primary practice location
155 County Rd
Cresskill, NJ 07626-2200
Mailing address
98 Ames Ave
Bergenfield, NJ 07621-1564
Phone (201) 803-9433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Charities, Diocese of Trenton | Multi-Specialty | Current | Accepting new patients |
| Aldad Medical NJ, P.C | Multi-Specialty | Current | Accepting new patients |
| Shine Medical Providers PC | Multi-Specialty | Past | Accepting new patients |
| Shine Medical of Ca PC | Multi-Specialty | Past | Accepting new patients |
Locations
221 River St
Ste 901
Hoboken, NJ 07030
Phone (201) 308-8252
383 W State St
Trenton, NJ 08618
Phone (609) 278-4933
39 N Clinton Ave
Trenton, NJ 08609
Phone (609) 394-5157
510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Trenton, NJ
- NPI 1306888656
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1679070023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 AMES AVE",
"city": "BERGENFIELD",
"state": "NJ",
"postal_code": "076211564",
"telephone_number": "201-803-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 COUNTY RD",
"city": "CRESSKILL",
"state": "NJ",
"postal_code": "076262200",
"telephone_number": "201-803-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVAS",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-11",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05779900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cresskill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.